Basic Studies on Locational Planning of Emergency Medical Facilities, Considering Patients' Accessibility to a Facility

1.近年来，特别是在熊本这样的省级地区，对改善紧急医疗服务的需求不断增加。本研究以熊本县为例，探讨了紧急医疗设施选址规划的技术和基本考虑：（1）利用患者对设施的可达性作为服务水平的替代，寻找此类设施的最佳选址的网络分析技术;（2）紧急医疗服务需求的定性和定量概况：（3）有效改善这些服务的政策.我们做了两种不同类型的调查：第一，我们调查了超过12000名患者的概况访问了熊本县的两个主要设施的紧急医疗服务;第二，选择一个特定的一周，我们调查了患者的数量访问了熊本市的医疗设施的紧急医疗服务。通过建立熊本县的主要道路网数据库和人口感知数据库，开发了一个规划支持系统，该系统可用于分析县内各小区的交通设施的可达性，并进行交通设施的最佳选址。该系统显示，该县南部地区的急诊医疗服务水平较低，建立新的设施势在必行.该研究的其他结果是：我们评估了位置优化的改进解决方案技术的效率：我们提出了各种数据，表明夜间对初级医疗护理的需求量很大，这些需求往往会干扰病情非常严重的患者的紧急医疗服务：我们提出了一种“患者筛选系统”，以缓解上述问题。我们做了一个总结报告，其中收集了所有已发表的论文。

1. Demands for improving emergency medical services have been increasing in these days, especially in a provincial area like Kumamoto. Selecting Kumamoto as the case, this research project aimed at examining techniques and basic considerations required for a locational planning of emergency medical facilities: (1) techniques of network analysis to find optimal location of such facilities, using accessibility of patients to facilities as a surrogate for a level of services: (2) both qualitative and quantitative profile of demands for emergency medical services: (3) some of polices effective to improve those services.2. We made surveys of two different types: firstly, we surveyed profiles of more than 12000 patients visited two major facilities of emergency medical servicies in the Kumamoto prefecture: secondly, selecting a specific week we surveyed number of patients visited medical facilities in the Kumamot City for emergency medical services.3. Building major road network data-base and population sensus data-base for the Kumamoto prefecture, we developed a planning support system which can be used firstly to analyze accesibility to and from the facilities for every small zone of the prefecture, and secondly to find optimal location of facilities. The system showed that a level of emergency medical services is low in southern part of the prefecture and that locating a new facilitiy is inevitable.4. Other results of the study are: we assessed an effciency of the improved solution technique of locational optimization: we presented various data which show that there are substantial amoutn of demands for primaly medical care in tha night time and that those demands tend to disturb emergency medical services for patients who are in a really serious condition: we proposed a "patient screening system" in order to ease such problem as described above.5. We made a summary report, in which all papers already published are collected.